Skip to main content
SpringerLink
Log in

Feeding methods, sleep arrangement, and infant sleep patterns: a Chinese population-based study

  • Original article
  • Published:
World Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Background

Findings from prior research into the effect of feeding methods on infant sleep are inconsistent. The objectives of this study were to examine infants’ sleep patterns by feeding methods and sleep arrangement from birth to eight months old.

Methods

This longitudinal cohort study enrolled 524 pregnant women at 34-41 weeks of gestation and their infants after delivery in 2006 and followed up until eight months postpartum. The study subjects were recruited from nine women and children hospitals in nine cities in China (Beijing, Chongqing, Wuhan, Changsha, Nanning, Xiamen, Xi’an, Jinan, and Hailin). Participating infants were followed up weekly during the first month and monthly from the second to the eighth month after birth. Twenty-four hour sleep diaries recording infants’ sleeping and feeding methods were administered based on caregiver’s self-report. Multivariable mixed growth curve models were fitted to estimate the effects of feeding methods and sleep arrangement on infants’ sleep patterns over time, controlling for maternal and paternal age, maternal and paternal education level, household income, supplementation of complementary food, and infant birth weight and length.

Results

Exclusively formula fed infants had the greatest sleep percentage/24 h, followed by exclusively breast milk fed infants and partially breast milk fed infants (P<0.01). Night waking followed a similar pattern. However, the differences in sleep percentage and night waking frequency between exclusively formula and exclusively breast milk fed infants weakened over time as infants developed. In addition, compared to infants with bed-sharing sleep arrangement, those with room sharing sleep arrangement had greater daytime and 24-hour infant sleep percentage, whereas those with sleeping alone sleep arrangement had greater nighttime sleep percentage.

Conclusions

Our data based on caregiver’s selfreport suggested that partial breastfeeding and bedsharing may be associated with less sleep in infants. Health care professionals need to work with parents of newborns to develop coping strategies that will help prevent early weaning of breastfeeding.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Sadeh A, Mindell JA, Luedtke K, Wiegand B. Sleep and sleep ecology in the first 3 years: a web-based study. J Sleep Res 2009;18:60–73.

    Article  PubMed  Google Scholar 

  2. Galland BC, Taylor BJ, Elder DE, Herbison P. Normal sleep patterns in infants and children: a systematic review of observational studies. Sleep Med Rev 2012;16:213–222.

    Article  PubMed  Google Scholar 

  3. Hayes MJ, Parker KG, Sallinen B, Davare AA. Bedsharing, temperament, and sleep disturbance in early childhood. Sleep 2001;24:657–662.

    PubMed  CAS  Google Scholar 

  4. Ball HL. Breastfeeding, bed-sharing, and infant sleep. Birth 2003;30:181–188.

    Article  PubMed  Google Scholar 

  5. Anuntaseree W, Mo-suwan L, Vasiknanonte P, Kuasirikul S, Ma-a-lee A, Choprapawan C. Night waking in Thai infants at 3 months of age: association between parental practices and infant sleep. Sleep Med 2008;9:564–571.

    Article  PubMed  Google Scholar 

  6. Mindell JA, Meltzer LJ, Carskadon MA, Chervin RD. Developmental aspects of sleep hygiene: Findings from the 2004 National Sleep Foundation Sleep in America Poll. Sleep Med 2009;10:771–779.

    Article  PubMed  Google Scholar 

  7. Kaley F, Reid V, Flynn E. Investigating the biographic, social and temperamental correlates of young infants’ sleeping, crying and feeding routines. Infant Behav Dev 2012;35:596–605.

    Article  PubMed  Google Scholar 

  8. Macknin ML, Medendorp SV, Maier MC. Infant sleep and bedtime cereal. Am J Dis Child 1989;143:1066–1068.

    PubMed  CAS  Google Scholar 

  9. Quillin SI, Glenn LL. Interaction between feeding method and co-sleeping on maternal-newborn sleep. J Obstet Gynecol Neonatal Nurs 2004;33:580–588.

    Article  PubMed  Google Scholar 

  10. Doan T, Gardiner A, Gay CL, Lee KA. Breast-feeding increases sleep duration of new parents. J Perinat Neonatal Nurs 2007;21:200–206.

    Article  PubMed  Google Scholar 

  11. Cohen Engler A, Hadash A, Shehadeh N, Pillar G. Breastfeeding may improve nocturnal sleep and reduce infantile colic: potential role of breast milk melatonin. Eur J Pediatr 2012;171:729–732.

    Article  PubMed  Google Scholar 

  12. Ramamurthy MB, Sekartini R, Ruangdaraganon N, Huynh DH, Sadeh A, Mindell JA. Effect of current breastfeeding on sleep patterns in infants from Asia-Pacific region. J Paediatr Child Health 2012;48:669–674.

    Article  PubMed  Google Scholar 

  13. Morrell J, Cortina-Borja M. The developmental change in strategies parents employ to settle young children to sleep, and their relationship to infant sleeping problems, as assessed by a new questionnaire: the Parental Interactive Bedtime Behavior Scale. Infant Child Dev 2002;11:17–41.

    Article  Google Scholar 

  14. Ball HL. Reasons to bed-share: why parents sleep with their infants. J Reprod Infant Psychol 2002;20:207–222.

    Article  Google Scholar 

  15. Santos IS, Mota DM, Matijasevich A, Barros AJ, Barros FC. Bed-sharing at 3 months and breast-feeding at 1 year in southern Brazil. J Pediatr 2009;155:505–509.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hunsley M, Thoman EB. The sleep of co-sleeping infants when they are not co-sleeping: evidence that co-sleeping is stressful. Dev Psychobiol 2002;40:14–22.

    Article  PubMed  Google Scholar 

  17. Mao A, Burnham MM, Goodlin-Jones BL, Gaylor EE, Anders TF. A comparison of the sleep-wake patterns of co-sleeping and solitary-sleeping infants. Child Psychiatry Hum Dev 2004;35:95–105.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Baddock SA, Galland BC, Bolton DP, Williams SM, Taylor BJ. Differences in infant and parent behaviors during routine bed sharing compared with cot sleeping in the home setting. Pediatrics 2006;117:1599–1607.

    Article  PubMed  Google Scholar 

  19. Ferber R. Sleeplessness in children. In: Ferber R, eds. Principles and practice of sleep medicine in the child. Philadelphia: Saunders, 1995: 79–90.

    Google Scholar 

  20. Sadeh A, Tikotzky L, Scher A. Parenting and infant sleep. Sleep Med Rev 2010;14:89–96.

    Article  PubMed  Google Scholar 

  21. Barnard KE, Eyres SJ. Child health assessment. Part 2, the first year of life. Washington DC: US. Government Printing Office, 1979.

    Google Scholar 

  22. Barr RG, Kramer MS, Boisjoly C, McVey-White L, Pless IB. Parental diary of infant cry and fuss behavior. Arch Dis Child 1988;63:380–387.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  23. Fazzi E, Zaccagnino M, Capsoni C, Orcesi S, Spada G, Cavallini A, et al. A questionnaire on sleep behaviour in the first years of life: preliminary results from a normative sample. Funct Neurol 2006;21:151–158.

    PubMed  Google Scholar 

  24. WHO, UNICEF, Ministry of Health’s Division of Primary Health Care and Maternal and Child Health. Breastfeeding consultation and training course (student handbook). Beijing: Beijing medical university and China xie-he medical university joint press, 1997.

    Google Scholar 

  25. Bry k, Stephen W, Raudenbush Anthony S. Hierarchical linear models: applications and data analysis methods. Thousand Oaks, CA: Sage Publications, 2002.

    Google Scholar 

  26. Quillin SI. Infant and mother sleep patterns during fourth postpartum week. Issues Compr Pediatr Nurs 1997;20:115–123.

    Article  PubMed  CAS  Google Scholar 

  27. Robinson S, Fall C. Infant nutrition and later health: a review of current evidence. Nutrients 2012;4:859–874.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Raphael D. Night waking: a normal response? J Pediatr 1976;88:169–170.

    Article  PubMed  CAS  Google Scholar 

  29. Rosen LA. Infant sleep and feeding. J Obstet Gynecol Neonatal Nurs 2008;37:706–714.

    Article  PubMed  Google Scholar 

  30. Wright P, MacLeod HA, Cooper MJ. Waking at night: the effect of early feeding experience. Child Care Health Dev 1983;9:309–319.

    Article  PubMed  CAS  Google Scholar 

  31. Blair PS, Ball HL. The prevalence and characteristics associated with parent-infant bed-sharing in England. Arch Dis Child 2004;89:1106–1110.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  32. Li S, Jin X, Yan C, Wu S, Jiang F, Shen X. Bed-and roomsharing in Chinese school-aged children: prevalence and association with sleep behaviors. Sleep Med 2008;9:555–563.

    Article  PubMed  Google Scholar 

  33. Horsley T, Clifford T, Barrowman N, Bennett S, Yazdi F, Sampson M, et al. Benefits and harms associated with the practice of bs: a systematic review. Arch Pediatr Adolesc Med 2007;161:237–245.

    Article  PubMed  Google Scholar 

  34. Green KE, Groves MM, Tegano DW. Parenting practices that limit transitional object use: an illustration. Early Child Dev Care 2004;174:427–436.

    Article  Google Scholar 

  35. Morrell J, Steele H. The role of attachment security, temperament, maternal perception, and care-giving behavior in persistent infant sleeping problems. Infant Ment Health J 2003;24:447–468.

    Article  Google Scholar 

  36. Mindell JA, Sadeh A, Wiegand B, How TH, Goh DY. Crosscultural differences in infant and toddler sleep. Sleep Med 2010;11:274–280.

    Article  PubMed  Google Scholar 

  37. Gu GX. Problems of overlooking psychosomatic health of only child and the countermeasures. Chin Gen Pract 2007;10:193–194. [In Chinese]

    Google Scholar 

  38. Hu LS, He DS, Huang J, Pan CB, Luo H, Deng DQ, et al. Survey on sleep status among preschool only children. Matern Child Health Care China 2006;2:264–266. [In Chinese]

    Google Scholar 

  39. Scher A, Asher R. Is attachment security related to sleep-wake regulation? Mother’s reports and objective sleep recordings. Infant Behav Dev 2004;27:288–302.

    Google Scholar 

  40. Sadeh A. Evaluating night wakings in sleep disturbed infants: a methodological study of parental reports and actigraphy. Sleep 1996;19:757–762.

    PubMed  CAS  Google Scholar 

  41. Asaka Y, Takada S. Comparing sleep measures of infants derived from parental reports in sleep diaries and acceleration sensors. Acta Paediatr 2011;100:1158–1163.

    Article  PubMed  Google Scholar 

  42. So K, Adamson TM, Horne RS. The use of actigraphy for assessment of the development of sleep/wake patterns in infants during the first 12 months of life. J Sleep Res 2007;16:181–187.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Children Health, National Center for Maternal and Children Health, Chinese Center for Disease Control and Prevention, Beijing, China

    Xiao-Na Huang, Hui-Shan Wang & Jing-Xiong Jiang

  2. Department of Epidemiology, Saint Louis University College for Public Health and Social Justice, St. Louis, MO, USA

    Jen-Jen Chang

  3. The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

    Lin-Hong Wang

  4. Bronchoscopy Center, Affiliated Children Hospital of Beijing Capital Medical University, Beijing, China

    Xi-Cheng Liu

  5. Department of Public Health, Peking University Health Science Center, Beijing, China

    Lin An

Authors
  1. Xiao-Na Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hui-Shan Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jen-Jen Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lin-Hong Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xi-Cheng Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jing-Xiong Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lin An
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lin-Hong Wang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Huang, XN., Wang, HS., Chang, JJ. et al. Feeding methods, sleep arrangement, and infant sleep patterns: a Chinese population-based study. World J Pediatr 12, 66–75 (2016). https://doi.org/10.1007/s12519-015-0012-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12519-015-0012-8

Key words

Search

Navigation